BILL NUMBER: AB 525	CHAPTERED  09/08/00

	CHAPTER   347
	FILED WITH SECRETARY OF STATE   SEPTEMBER 8, 2000
	APPROVED BY GOVERNOR   SEPTEMBER 7, 2000
	PASSED THE ASSEMBLY   AUGUST 24, 2000
	PASSED THE SENATE   AUGUST 23, 2000
	AMENDED IN SENATE   AUGUST 14, 2000
	AMENDED IN SENATE   MARCH 27, 2000
	AMENDED IN ASSEMBLY   JANUARY 26, 2000
	AMENDED IN ASSEMBLY   JUNE 1, 1999
	AMENDED IN ASSEMBLY   APRIL 5, 1999

INTRODUCED BY   Assembly Members Kuehl and Thomson
   (Coauthors:  Assembly Members Aroner, Calderon, Firebaugh, Honda,
Jackson, Keeley, Longville, Mazzoni, Romero, Shelley, and Wildman)
   (Coauthors:  Senators Figueroa, Hayden, and Solis)

                        FEBRUARY 18, 1999

   An act to add Section 1363.02 to, and to add Chapter 2.15
(commencing with Section 1339.80) to Division 2 of, the Health and
Safety Code, to add Section 10604.1 to the Insurance Code, and to add
Section 14016.8 to the Welfare and Institutions Code, relating to
health care coverage.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 525, Kuehl.  Health benefits:  reproductive health care.
   Existing law provides for the regulation and licensing of health
care service plans by the Department of Managed Care, effective no
later than July 1, 2000, or earlier pursuant to an executive order of
the Governor.  A willful violation of the provisions governing
health care service plans is a crime.  Existing law provides for the
regulation of disability insurers by the Department of Insurance and
for administration of the Medi-Cal program by the State Department of
Health Services.
   This bill would require certain health care service plans,
disability insurers, and Medi-Cal managed care plans to provide a
specified written statement to recipients of health care services for
the purpose of informing them relative to certain reproductive
health care issues, as specified.
   Because a violation of the bill's requirements with respect to
health care service plans would be a crime, this bill would impose a
state-mandated local program by creating a new crime.
  The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state.  Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  Chapter 2.15 (commencing with Section 1339.80) is added
to Division 2 of the Health and Safety Code, to read:

      CHAPTER 2.15.  HOSPITAL AND OTHER PROVIDER REQUIREMENTS FOR
DISSEMINATION OF INFORMATION RELATING TO REPRODUCTIVE HEALTH SERVICES

   1339.80.  Hospitals and other providers are not required to post,
send, deliver, or otherwise provide the statement described in
paragraph (1) of subdivision (b) of Section 1363.02, paragraph (1) of
subdivision (b) of Section 10604.1 of the Insurance Code, or
paragraph (1) of subdivision (b) of Section 14016.8 of the Welfare
and Institutions Code.
   1339.81.  For purposes of this chapter, "provider" means any
professional person, organization, health facility, or other person
or institution licensed by the state to deliver or furnish health
care services.
  SEC. 2.  Section 1363.02 is added to the Health and Safety Code, to
read:
   1363.02.  (a) The Legislature finds and declares that the right of
every patient to receive basic information necessary to give full
and informed consent is a fundamental tenet of good public health
policy and has long been the established law of this state.  Some
hospitals and other providers do not provide a full range of
reproductive health services and may prohibit or otherwise not
provide sterilization, infertility treatments, abortion, or
contraceptive services, including emergency contraception.  It is the
intent of the Legislature that every patient be given full and
complete information about the health care services available to
allow patients to make well informed health care decisions.
   (b) On or before July 1, 2001, a health care service plan that
covers hospital, medical, and surgical benefits shall do both of the
following:
   (1) Include the following statement, in at least 12-point boldface
type, at the beginning of each provider directory:

   "Some hospitals and other providers do not provide one or more of
the following services that may be covered under your plan contract
and that you or your family member might need:  family planning;
contraceptive services, including emergency contraception;
sterilization, including tubal ligation at the time of labor and
delivery; infertility treatments; or abortion.  You should obtain
more information before you enroll.  Call your prospective doctor,
medical group, independent practice association, or clinic, or call
the health plan at (insert the health plan's membership services
number or other appropriate number that individuals can call for
assistance) to ensure that you can obtain the health care services
that you  need."

   (2) Place the statement described in paragraph (1) in a prominent
location on any provider directory posted on the health plan's
website, if any, and include this statement in a conspicuous place in
the plan's evidence of coverage and disclosure forms.
   (c) A health care service plan shall not be required to provide
the statement described in paragraph (1) of subdivision (b) in a
service area in which none of the hospitals, health facilities,
clinics, medical groups, or independent practice associations with
which it contracts limit or restrict any of the reproductive services
described in the statement.
   (d) This section shall not apply to specialized health care
service plans or Medicare supplement plans.
  SEC. 3.  Section 10604.1 is added to the Insurance Code, to read:
   10604.1.  (a) The Legislature finds and declares that the right of
every patient to receive basic information necessary to give full
and informed consent is a fundamental tenet of good public health
policy and has long been the established law of this state.  Some
hospitals and other providers do not provide a full range of
reproductive health services and may prohibit or otherwise not
provide sterilization, infertility treatments, abortion, or
contraceptive services, including emergency contraception.  It is the
intent of the Legislature that every patient be given full and
complete information about the health care services available to
allow patients to make well informed health care decisions.
   (b) On or before July 1, 2001, every disability insurer that
provides coverage for hospital, medical, or surgical benefits, and
which provides a list of network providers to prospective insureds
and insureds, shall do both of the following:
   (1) Include the following statement, in at least 12-point boldface
type, at the beginning of each provider directory:

   "Some hospitals and other providers do not provide one or more of
the following services that may be covered under your policy and that
you or your family member might need:  family planning;
contraceptive services, including emergency contraception;
sterilization, including tubal ligation at the time of labor and
delivery; infertility treatments; or abortion.  You should obtain
more information before you become a policyholder or select a network
provider.  Call your prospective doctor or clinic, or call the
insurer at (insert the insurer's membership services number or other
appropriate number that individuals can call for assistance) to
ensure that you can obtain the health care services that you  need."

   (2) Place the statement described in paragraph (1) in a prominent
location on any provider directory posted on the insurer's website,
if any, and include this statement in a conspicuous place in the
insurer's evidence of coverage and disclosure forms.
   (c) A disability insurer shall not be required to provide the
statement described in paragraph (1) of subdivision (b) in a service
area in which none of the hospitals, health facilities, clinics,
medical groups, or independent practice associations with which it
contracts limit or restrict any of the reproductive services
described in the statement.
   (d) This section shall not apply to vision-only, dental-only,
accident-only, specified disease, hospital indemnity, Medicare
supplement, long-term care, or disability income insurance.
  SEC. 4.  Section 14016.8 is added to the Welfare and Institutions
Code, to read:
   14016.8.  (a) The Legislature finds and declares that the right of
every patient to receive basic information necessary to give full
and informed consent is a fundamental tenet of good public health
policy and has long been the established law of this state.  Some
hospitals and other providers do not provide a full range of
reproductive health services and may prohibit or otherwise not
provide sterilization, infertility treatments, abortion, or
contraceptive services, including emergency contraception.  It is the
intent of the Legislature that every patient be given full and
complete information about the health care services available to
allow patients to make well informed health care decisions.
   (b) On or before July 1, 2001, the department shall:
   (1) Ensure that all Medi-Cal beneficiaries receive the following
statement by the methods described in paragraphs (2) to (6),
inclusive:

   "Some hospitals and other providers do not provide one or more of
the following services that may be covered under your plan contract
and that you or your family member might need:  family planning;
contraceptive services, including emergency contraception;
sterilization, including tubal ligation at the time of labor and
delivery; infertility treatments; or abortion.  You should obtain
more information before you enroll.  Call your prospective doctor or
clinic, or call the Medi-Cal managed care plan at (insert the plan's
membership services number or other appropriate number that
individuals can call for information) to ensure that you can obtain
the health care services that you  need."
   (2) Require that each Medi-Cal managed care plan provide the
statement described in paragraph (1), in at least 12-point boldface
type at the beginning of each provider directory.
   (3) Require that each Medi-Cal managed care plan place the
statement described in paragraph (1) in a prominent location on any
provider directory posted on the plan's website, if any, and include
this statement in a conspicuous place in the plan's evidence of
coverage and disclosure forms, if any.
   (4) Require that the statement described in paragraph (1) be
included in the health care option activities described in Sections
14016.5, 14087.305, subdivision (e) of Section 14089, and paragraph
(2) of subdivision (f) of Section 14408.
   (5) Require each county organized health system to provide to
Medi-Cal beneficiaries the statement described in paragraph (1).
This statement shall be provided in writing in at least 12-point
boldface type prior to enrollment, prior to selection of a primary
care provider, and  on an annual basis.
   (6) Ensure that the statement described in paragraph (1) is
provided to any other Medi-Cal managed care beneficiary who would not
receive the statement under the provisions of paragraphs (2) to (5),
inclusive.  This statement shall be provided in writing in at least
12-point boldface type prior to enrollment, prior to selection of a
primary care provider, and  on an annual basis.
   (c) The requirement to provide the statement described in
paragraph (1) of subdivision (b) shall apply to Medi-Cal managed care
programs, including, but not limited to, the following programs:
   (1) In areas where the department is contracting with persons or
entities that are contracting with, or governed, owned, or operated
by, either a county board of supervisors or a county special
commission, or a county health authority, operating under Article 2.8
(commencing with Section 14087.5) or Article 7 (commencing with
Section 14490) of Chapter 8, or Chapter 3 (commencing with Section
101675) of Part 4 of Division 101 of the Health and Safety Code.
   (2) In areas specified by the director for expansion of the
Medi-Cal managed care program under Section 14087.3, including where
the department is contracting with prepaid health plans, including
prepaid health plans that are contracting with, governed, owned, or
operated by a county board of supervisors, a county special
commission or county health authority authorized by Sections 14018.7,
14087.31, 14087.316, 14087.35, 14087.36, 14087.38, and 14087.9605.
   (3) Where the department has entered into contracts with prepaid
health plans or primary care case management providers pursuant to
Article 2.9 (commencing with Section 14088) and Chapter 8 (commencing
with Section 14200).
   (4) Where the department or the California Medical Assistance
Commission has entered into contracts with any persons or entities
pursuant to Section 14087.47, Article 2.91 (commencing with Section
14089), or Article 2.97 (commencing with Section 14093).
   (d) A Medi-Cal managed care plan shall not be required to provide
the statement described in paragraph (1) of subdivision (b) in a
service area in which none of the hospitals, health facilities,
clinics, medical groups, or independent practice associations with
which it contracts limit or restrict any of the reproductive services
described in the statement.
   (e) This section shall not apply to specialized health care
service plans.
  SEC. 5.  No reimbursement is required by this act pursuant to
Section 6 of Article XIIIB of the California Constitution because the
only costs that may be incurred by a local agency or school district
will be incurred because this act creates a new crime or infraction,
eliminates a crime or infraction, or changes the penalty for a crime
or infraction, within the meaning of Section 17556 of the Government
Code, or changes the definition of a crime within the meaning of
Section 6 of Article XIIIB of the California Constitution.
